Charitable Care Policy

It is the policy of Elliot Hospital to offer medical care to all who may have difficulty in paying for services
due to limited income without regard to their race, religion, sex, or age.

Generally, individuals whose income falls below 400% of the federal poverty guidelines qualify for some
level of assistance for medically necessary services. The charitable care provided can range from the
patient having no financial obligation, to a percentage of their hospital charges.

If a patient believes that they may qualify for charitable care, they should call 603-663-2571 (8:00-4:30) to
schedule an appointment with the charitable care coordinator.

Charitable care will be available only for medical services that are reasonable and necessary for the
diagnosis and treatment of illness or injury. Non-medically necessary services will not be considered.

Services that are considered cosmetic or patient convenience would not qualify for charitable care. Also
any services that are elective and are not medically urgent or emergent do not qualify for charitable care.
Patient Financial Services will render determination of eligibility in writing within fourteen days of receipt of
the complete application.